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Ann Thorac Surg 1983;35:406-414
© 1983 The Society of Thoracic Surgeons

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Articles

The Effect of Prostaglandin E₁ in Patients Undergoing Clinical Cardiopulmonary Bypass

From the Departments of Experimental Surgery, Anesthesiology, and Thoracic Surgery, University Hospital Groningen, Groningen, The Netherlands

Accepted for publication April 29, 1982.

^* Address reprint requests to Dr. Wildevuur, Department of Experimental Surgery, University Hospital Groningen, Oostersingel 59, 9713 EZ Groningen, The Netherlands

The effect of prostaglandin E₁ (PGE₁) on protection of platelets during cardiopulmonary bypass (CPB) was evaluated in 9 patients, who were compared with an identical control group of 10 patients undergoing coronary artery bypass grafting. To evaluate the hemodynamic side-effects, PGE₁ (0.05 µg/kg/min) was infused prior to CPB, resulting in a 26% drop in mean systemic arterial pressure. With this dose, no inhibition of the adenosine diphosphate-induced aggregation could be measured in the pulmonary artery sample. During CPB, the same infusion dose resulted in a severe drop in systemic arterial pressure below 50 mm Hg in 7 of the 9 patients. In 5 of these patients, volume load and phenylephrine infusion could not compensate for the pressure drop, and PGE₁ had to be reduced to 0.02 µg/kg/min. Platelet aggregation was reduced significantly in the PGE₁-treated group compared with the control group, but not completely inhibited during CPB. However, in the postbypass period no platelet preservation was seen in the PGE₁ group. In both groups, platelet number and function were equally low. No differences were measured in blood loss or blood transfusion requirements. Except for hypotension, no side-effects of the PGE₁ treatment were seen. It is concluded that the hypotension caused by minimal doses of PGE₁ during CPB precluded using higher doses, which might have had a greater effect on platelet inhibition. These hypotensive side-effects should be reduced or eliminated before PGE₁ can be expected to have the same protective effect on platelet damage that has been demonstrated in animal experiments.

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				M. P. Harder, L. Eijsman, K. J. Roozendaal, W. van Oeveren, and C. R. H. Wildevuur Aprotinin reduces intraoperative and postoperative blood loss in membrane oxygenator cardiopulmonary bypass Ann. Thorac. Surg., June 1, 1991; 51(6): 936 - 941. [Abstract] [PDF]